Objectives: To evaluate the prevalence of sleep disorders diagnosed by pediatric primary care providers within a large healthcare network, utilizing the International Classification of Diseases, Ninth Revision (ICD-9) codes. A secondary goal was to explore the demographic factors associated with these diagnoses and the frequency of medication prescriptions intended for sleep disorder treatment.
Methods: A retrospective review of electronic health records was conducted, encompassing 154,957 patients aged 0 to 18 years. These patients were seen for well-child visits in 2007 within a primary care network. Data extraction included ICD-9 sleep disorder diagnoses, patient demographics, co-occurring conditions such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD), provider type, and prescribed medications.
Results: The study revealed that 3.7% of the pediatric population received an ICD-9 diagnosis for a sleep disorder. The most frequently observed diagnoses were sleep disorder not otherwise specified, enuresis (bedwetting), and sleep-disordered breathing. Predictive factors for sleep disorder diagnoses varied across different developmental age groups. These factors included growth parameters, the presence of comorbid ADHD or ASD, and the type of healthcare provider. Furthermore, 6.1% of the children in the study sample were prescribed medications with potential sleep-related applications.
Conclusions: This research represents a significant early effort to comprehensively analyze ICD-9 sleep diagnoses as assigned by primary care physicians in a large, representative pediatric cohort aged 0 to 18 years. The identified prevalence of 3.7% for ICD-9 sleep diagnoses is notably lower than rates reported in broader epidemiological studies. This discrepancy suggests a potential underdiagnosis of sleep disorders by primary care providers in children and adolescents. Given that sleep disorders are often treatable when correctly identified, these findings underscore a critical need for enhanced education and resources to support primary care providers in the accurate diagnosis and effective management of pediatric sleep disorders.
